Global Health and the Millennium Development Goals When Things go Wrong: Staying and Getting out of Trouble Cynthia Haq MD Director, Center for Global Health University of Wisconsin-Madison American Academy of Family Physicians CiHI Meeting Broomfield, Colorado, September, 2009

UW-Madison Center for Global Health Medicine and Public Health NursingPharmacy Veterinary Medicine International Studies

Global Health and University Engagement Agricultural & Life Sciences Area Studies Arts & Sciences Business Center for Global Health Division of International Studies Education Engineering Law School Nelson Institute of Environmental Studies And more!

Education for Health for UW Students, Staff, Faculty … and Communities

Global Health in Medical Schools and AHCs Global health curriculum Global health curriculum Cross cultural communication skills Cross cultural communication skills Interdisciplinary team practice Interdisciplinary team practice Community health efforts-commitment to underserved patients, the poor, uninsured and disadvantaged Community health efforts-commitment to underserved patients, the poor, uninsured and disadvantaged Global health electives Global health electives Field courses Field courses Global health certificate or tracks Global health certificate or tracks MPH-global health emphasis MPH-global health emphasis students abroad per year students abroad per year

UW-Madison Center for Global Health Principles Equity Equity Reciprocity Reciprocity Sustainability Sustainability Interdisciplinarity Interdisciplinarity Quality and safety Quality and safety Public health Public health

Staying out of Trouble- Preparation Selection of faculty and students Selection of faculty and students Building relationships-selecting sites Building relationships-selecting sites Planning agenda with local hosts Planning agenda with local hosts Preparation of students and faculty Preparation of students and faculty Insurance; medical and evacuation Insurance; medical and evacuation Medical preparation-travel health Medical preparation-travel health Registration; emergency contact and US embassy Registration; emergency contact and US embassy

Staying out of Trouble in the Field Scheduling with flexibility Scheduling with flexibility Food and water Food and water Transportation; vehicle and driver Transportation; vehicle and driver Personal items Personal items Lodging Lodging Night life Night life Donations and gifts Donations and gifts

What to do when things go wrong ”Don’t expect what you expect!” ”Don’t expect what you expect!” Illnesses Illnesses Accidents Accidents Culture shock Culture shock Conflicts Conflicts Emergencies at home Emergencies at home

Case Study – War You have moved with your husband and 4 children to Pakistan as part of a Fulbright program to develop family medicine in Pakistan. You have moved with your husband and 4 children to Pakistan as part of a Fulbright program to develop family medicine in Pakistan. You are contacted by the US Embassy requesting that you pack your bags and gather your husband and children to take the next flight out of the country….. You are contacted by the US Embassy requesting that you pack your bags and gather your husband and children to take the next flight out of the country…..

Case Study-Illness You are leading a field course with 14 students in Uganda. You are leading a field course with 14 students in Uganda. Sharon, a first year medical student becomes ill with a severe headache, body aches, high fever and delirium….. Sharon, a first year medical student becomes ill with a severe headache, body aches, high fever and delirium…..

Case Study-Accident One of your senior faculty is leading a one month filed course with 12 medical students in Malawi. One of your senior faculty is leading a one month filed course with 12 medical students in Malawi. You receive a call notifying you that the van carrying the faculty and students back to the airport was struck by a train. The driver was killed and several people are critically injured. You receive a call notifying you that the van carrying the faculty and students back to the airport was struck by a train. The driver was killed and several people are critically injured.

Case Study-Culture Shock You are leading a field course and note that one of the students seems withdrawn, sad and aloof. She is reluctant to join group activities and often complains about local conditions. Her behavior is considered rude by local hosts. You are leading a field course and note that one of the students seems withdrawn, sad and aloof. She is reluctant to join group activities and often complains about local conditions. Her behavior is considered rude by local hosts.

Case Study – Conflict You are leading a group of 16 students, two of whom are openly gay males, in a country where homosexuality is considered a criminal offense, punishable by imprisonment. You are leading a group of 16 students, two of whom are openly gay males, in a country where homosexuality is considered a criminal offense, punishable by imprisonment.

Case Study- Gifts and Donations US students have raised over $5000 to contribute to an orphanage in the host country where they will study. Local hosts learn about the funds and bring many additional requests for financial and material donations. US students have raised over $5000 to contribute to an orphanage in the host country where they will study. Local hosts learn about the funds and bring many additional requests for financial and material donations. The van students and you are traveling in is surrounded by beggars at every stop in the city. The van students and you are traveling in is surrounded by beggars at every stop in the city.

Case Study-Ethical Dilemma Second year medial students in a remote field site are expected to deliver medical services to critically ill patients. Second year medial students in a remote field site are expected to deliver medical services to critically ill patients. Human health professional resources are limited; your students are eager to contribute, but you are concerned they may not be adequately prepared…. Human health professional resources are limited; your students are eager to contribute, but you are concerned they may not be adequately prepared….

Case Study- Health Challenge You and your students are engaged in field work in a remote site where the local HIV prevalence is 10%. You and your students are engaged in field work in a remote site where the local HIV prevalence is 10%. One of the students assisting in the hospital sustains a needle stick injury….. One of the students assisting in the hospital sustains a needle stick injury…..

Case Study- Request to Study Abroad Two first year medical students approach you with plans to study in Kashmir. They need your approval and guidance. Two first year medical students approach you with plans to study in Kashmir. They need your approval and guidance. They hope to assist earthquake victims, they hope to work with what appears to be a well-organized not-for-profit organization that conducts programs in the region…… They hope to assist earthquake victims, they hope to work with what appears to be a well-organized not-for-profit organization that conducts programs in the region……

Case Study Your examples….. Your examples…..